Individual provider · Type 1 NPI

Wilben Andy Lariviere, PA

Medical Physician Assistant · Mesa, AZ

NPI number 1154076933 Active

Practice location

2045 S Vineyard Ste 119
Mesa, AZ 85210-6890

Call (480) 300-4646 Map

Fax (480) 300-4646

Other practice locations

  • 8260 NE 2nd Ave, Miami, FL 33138-3808 · (305) 757-9555
  • 333 W Thomas Rd Ste 208A, Phoenix, AZ 85013-4425 · (480) 300-4646

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X1212-P.A. (PR)

Medical Physician Assistant: Definition to come...

3 other providers at this address

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About NPI 1154076933

Wilben Andy Lariviere, PA's National Provider Identifier is 1154076933, issued on Feb 19, 2022. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Mesa, AZ. The record was last updated on Sep 11, 2025.